冠心病患者应用IABP后血小板减少临床分析

目的：探讨冠心病患者应用IABP后血小板变化规律,分析血小板变化对患者预后的影响。方法：回顾性分析2012年1月~2014年7月河南科技大学第一附属医院96例置入IABP冠心病患者临床资料,利用重复测量资料的方差分析分析应用IABP后血小板变化规律。根据冠心病治疗方式不同,分为手术组、介入组和药物组,比较三组患者血小板变化及其对患者预后的影响。结果：96例患者应用IABP时间(97.10±64.66)h,应用IABP后即出现血小板下降,第2-4天血小板最低,随后开始上升,手术组与介入组、药物组比较血小板减少差异具有统计学意义,药物组预后与手术组、介入组比较差异具有统计学意义,死亡及自动出院率更高。血小板减少与血小板正常患者预后比较差异无统计学意义。结论：冠心病患者应用IABP后血小板呈先下降后上升的趋势,最低值在2-4天,手术组血小板低于介入及药物组,血小板下降与冠心病预后无关,但药物组患者死亡率高于手术组及介入组。

A Clinical Analysis of Thrombocytopenia after Implanting IABP in Patients with Coronary Atherosclerotic Heart Disease

Objective: To analysis the change rule of platelets after implantation of IABP in the patients with coronary atherosclerotic heart disease and the influence on prognosis. Methods: A retrospective analysis is used. Clinical data of 96 IABP patients from January 2012 to July 2014 in the First Affiliated Hospital of Henan University of Science and Technology were analysized to find the change rule of platelets after IABP. According to the different ways of treatment, patients were divided into surgical group, intervention group and drug group, so as to compare the differences in platelet change and the influence on prognosis. Results: The IABP time was (97.10 ± 64.66) hours. The platelets declined after the application of IABP. The platelet minimum occurred 2-4 days after IABP, then it begun to rise. The platelets of the surgical patients declined significantly compared with interventional group and the drug group. As to the prognosis, the drug group had a higher rate of death and automatic discharge, which was significantly different compared with the surgical group and intervention group. There were no statistically significant differences in the prognosis between patients with thrombocytopenia and patients with normal platelets. Conclusion: The platelets of the patients with coronary heart disease after the application of IABP showed a trend of declining first and rising then. The platelet minimum occurred 2-4 days after IABP. The platelets of the surgical were significantly lower than intervention and drug groups. The thrombocytopenia had little to do with the prognosis of coronary heart disease. But the mortality rate of drug group patients is higher than surgical group and intervention group.